Old Vicarage Care Home

Updated 30 June 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection prevention and control measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection team consisted of one inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service. The Expert by Experience did not visit the care home but supported the inspection by telephoning a sample of relatives of the people who live in the care home; and obtained feedback about their experience of the service.

Service and service type

Old Vicarage is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Old Vicarage is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with seven people who used the service and a person’s relative. We also spoke with seven staff members including, registered manager, carer, activity worker, catering staff, admin worker and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We also observed interactions between staff and people. We reviewed a range of records. This included two people's care records (in whole or in part), risk assessments and multiple medication records. We looked at three staff files in relation to recruitment and pre-employment checks.

After the inspection

The Expert by Experience spoke on the telephone with 12 relatives of people who used the service. We received feedback on the service, by email or phone, from 16 members of the Old Vicarage staff team. A variety of records relating to the management of the service, including policies and procedures, were also reviewed. We reviewed care plans, looked at training and quality assurance data, and continued to seek clarification from the provider to validate evidence found.

Updated 30 June 2022

About the service

Old Vicarage care home is a residential care home providing personal and nursing care to up to 38 people. The service provides support to older people. The Old Vicarage consists of an adapted building which has also been extended with purpose-built facilities. At the time of our inspection there were 24 people using the service.

People’s experience of using this service and what we found

People lived in a care home which was generally clean, but infection control arrangements were negatively affected by the need for some areas of the care home to be refurbished.

Although people received the necessary support, the provider’s records did not always contain details of the repositioning, and regular continence care, checks carried out by staff to reduce people’s risk of skin breakdown.

We have made a recommendation about ensuring the repositioning and continence checks of people are recorded.

People told us they felt safe in the care home and care staff had received the necessary safeguarding training. There were enough suitably trained staff to meet people’s assessed care needs. People’s prescribed medicines were safely managed, and the provider had improved their medicines audit processes.

People who needed help to move did not always have the correct hoist sling equipment available. However, this was addressed by the registered manager during the inspection.

Care plans, on the provider’s electronic care record system, were not yet fully in place, and staff did not always use the electronic record system effectively. People received appropriate care, but the provider’s care records did not effectively evidence that.

We have made a recommendation about ensuring care records of all the support provided to people by staff are accurate and complete.

People gave us mixed feedback about the meals. We saw they were appetising and well presented, but the provider was in the process of reviewing their menu to take account of people’s preferences.

Refurbishment was underway, and the provider had a plan for this, but some areas of the care home were not in good decorative condition.

People’s care plans were in the process of being transferred onto a new electronic care record system and did not always contain evidence of involvement by people or their relatives in planning the care they received.

People were treated with kindness and compassion by the care staff. Personal care was delivered with due regard for privacy and dignity. People told us the staff were friendly towards them.

Call bell devices were not always accessible to people. However, this was addressed by the registered manager during the inspection.

People told us they enjoyed the activities which were available to them and relatives told us they had seen an improvement in the range of available activities.

Contact with families had been maintained during the COVID-19 pandemic, as far as possible. Formal complaints were rare and were responded to appropriately. However, relatives told they had ongoing concerns about the management of people’s laundry which had not been effectively addressed.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for the service, under the previous provider, was Good; published on 14 September 2018. The new provider registered with us on 19 December 2020, and this is the first inspection since the new provider took over the service.

Why we inspected

This inspection was prompted by a review of the information we held about this service. We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.